Highlights
- •In patients with newly diagnosed atrial fibrillation the distribution of BMI differed among the continents.
- •An increased BMI was associated with a lower probability of non-prescription of OACs, as compared with a normal BMI.
- •The probability of non-prescription of OACs was increased in the Asia or North America regions, as compared with Europe.
Abstract
Objective
To investigate the association between body mass index (BMI) and oral anticoagulant
(OAC) prescription in atrial fibrillation (AF).
Methods
Patients with newly diagnosed non-valvular AF (<3 months) with ≥1 stroke risk factors
enrolled in the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients
with Atrial Fibrillation (GLORIA-AF) in Asia, Europe and North America were evaluated.
Results
The cohort (n = 13,793) comprised patients from all BMI categories (kg/m2): 1.4% were underweight (<18.5), 27.3% had a normal BMI (18.5 to <25), 37.9% were
overweight (25 to <30), 19.3% were moderately obese (30 to <35), and 12.7% were morbidly
obese (≥35). The highest proportion of Asians had a BMI of 18.5 to <25 kg/m2, while the highest proportion of patients from Europe and North America were overweight
and a substantial proportion of North Americans morbidly obese. In the multivariable
analysis, the probability ratio of non-prescription of OAC, as compared to normal
BMI, decreased for overweight (RR = 0.907), moderately obese (RR = 0.802) and severe
very severe obese patients (RR = 0.659). Moreover, the probability ratio of non-prescription
of OACs was increased in the Asia or North America regions, as compared with Europe,
in patients aged <65 years or female patients, as well as in patients with prior bleeding
or vascular disease.
Conclusions
The distribution of BMI differed among the continents. An increased BMI was associated
with a lower probability of non-prescription of OACs, as compared with a normal BMI.
The probability of non-prescription of OACs was increased in the Asia or North America
regions, as compared with Europe.
Keywords
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Article info
Publication history
Published online: May 14, 2020
Accepted:
April 13,
2020
Received in revised form:
April 8,
2020
Received:
February 26,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
